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Citation
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Yamagami K, Kurogi R, Kurogi A, Nishimura K, Onozuka D, Ren N, Kada A, Nishimura A, Arimura K, Ido K, Mizoguchi M, Sakamoto T, Kayama T, Suzuki M, Arai H, Hagihara A, Iihara K. World Neurosurg. 2019; ePub(ePub): ePub. |
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Affiliation
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Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. |
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Abstract
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BACKGROUND: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades due to rapid advances in aging societies. We assessed the influence of age on outcomes of TBI patients and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients.
METHODS: Using a nationwide database, we analyzed data from 5,651 TBI patients. Univariate analysis was conducted to compare patient demographics, neurological status on admission, radiological findings, systemic complication rates, length of hospital stay, in-hospital mortality rates, and home discharge rates between elderly and non-elderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients.
RESULTS: Overall in-hospital mortality rate was significantly higher in elderly patients (12.8% vs. 19.3%, P < 0.001). In-hospital mortality rates of elderly patients with mild TBI increased significantly at >7 days after admission, whereas those of elderly patients with moderate or severe TBI were significantly higher immediately after admission. Age (odds ratio (OR), 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001) and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly TBI patients.
CONCLUSIONS: Elderly patients with TBI displayed significantly higher in-hospital mortality rates. Delayed increases in in-hospital mortality rates were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.
Copyright © 2019 Elsevier Inc. All rights reserved.
Language: en |